Hansen's (Lec 4) Study notes

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University of Toronto Scarborough
Health Studies
Caroline Barakat

Hansen's Disease/Leprosy (Lecture 4) Clinical Manifestations: oBacillus multiplies quite slowly • Usually in sheaths of peripheral nerves • Average multiplying time is 12-14 days o Incubation period: 3-5 years oNormally passed on from individual to individual with sustained exposure o Spectral disease • Symptoms eventually worsen • Takes several years for worst phases of disease to develop • Immune system's strength is a big factor • There is a possibility that immune system is capable of keeping disease from developing oTypically first appears on the skin as a patch or area thickened and differing in color oClinical features vary from one sufferer to another o Usually very distinguishable • Area is unresponsive to touch or pain oThe "lion face" oMost common cause of death in leprosaria is TB Leprosy - Basic information & Etiology o Caused by bacteria: mycobacterium leprae • Occurs naturally only in humans • Leprosy bacillus o Chronic, debilitating and disfiguring disease oMentioned in the Roman Catholic bible oKnown as the "Disease of the Soul" oSymptoms are typically visible oThought of as a punishment from God to sinners o Was first believed to have been hereditary Leprosy can affect all people oNo one is ultimately susceptible oCommon in ages 10-14 and 25-44 • Rarely seen in infants oConsidered a disease of low virulence oBacilli are shed from the skin Most bacilli are found in the nasal secretions -> one individual can shed 100 viable bacterium from the nose a day oRoute of entry into body still remains uncertain • May be through inhalation oMainly affects skin, mucous and nerve membranes oNot highly contagious History oMay have originated in Fear East Asia oFirst documented in: • Egypt 1550 BC -> papyrus document • India approximately 600 BC -> mentioned in various writings • Greece 320 BC -> mentioned in records, after the army of Alexander the Great returned from India • Rome 62 BC -> with the return of Pompeii's troops from Asia oLepers were stigmatized from the community o Mid 12th century, lepers lost their civic status oIn the 13th and 14th centuries, they were either buried or burned alive o 13th century, 19000 leprosaria were in use oDisease declined around 1350 AD • Disappeared in Europe in the 16th/17th century • But peaked in North America instead oLegendary symbols of the leper: • Yellow cross sewn on to their clothes • A clapper or bell to warn those who might get too close • A long pole in order to point to items that they wished to buy o Medical evidence for leprosy's changing incidence and prevalence over time oHistorical problems of the past 250 years o Viewed as both chosen and rejected by God • Consequently not exiled like criminals, but rather made to live apart of the community as if the living dead • "dead to society" o"Mass of Separation" -> the ceremony/ritual for lepers oDr. Aramaur Hansen of Norway discovered the leprosy germ under a microscope in 1873 oMost societies of the past denied legal
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